Verbal Repetition in the Reappraisal of Contamination-Related Thoughts

Background: Acceptance and Commitment Therapy advocates use of cognitive defusion techniques to reduce the distress evoked by negative thoughts, including verbal repetition (VR). In VR, a negative word is repeated until its semantic meaning is diluted (i.e. until semantic satiation is achieved). The present two studies examined whether VR is more effective than brief imaginal exposure (IE) and no intervention (CONT) in the reappraisal of contamination-related thoughts.

Method: Participants high in contamination fears identified their most distressing thoughts and were randomly assigned to VR, IE, or CONT. A category membership decision task was also conducted to determine if VR produced semantic satiation.

Results: In Study 1, there was no evidence of semantic satiation. Significant reductions in negative response to the thoughts was observed immediately following VR, but not IE or CONT; however, at one-week follow-up, both VR and IE groups reported similar reductions. In Study 2, the effects of VR and IE practice between post-intervention and follow-up were examined, as well as changes in behavioural avoidance. VR was found to produce semantic satiation of contamination thoughts, and VR was associated with less negative response at follow-up relative to IE and CONT, but the degree of satiation was not associated with the decreases in negative response. Only IE produced decreases in behavioural avoidance and vigilance monitoring.

Conclusions: Taken together, these results suggest that VR may have potential as an additional strategy for managing obsessional thoughts, but more research is warranted.